NR 547 CEA FINAL EXAM QUESTIONS & ANSWERS TEST BANK | ADVANCED PRACTICE HEALTH ASSESSMENT, SYSTEM-BASED DIAG… EXAM
P R O F E S S I O N A L P R A C T I C E M AT E R I A L S
NR 547 CEA Final Exam Questions & Answers
Test Bank | Advanced Practice Health
Assessment, System-Based Diagnosis &
Clinical Case Scenarios | Chamberlain |
2026/2027
Verified Answers Exam Ready With Rationales
100 QUESTIONS
DOCUMENT OVERVIEW
This document provides 100 advanced practice health assessment questions with their correct answers and
detailed explanations. Covering system-based diagnosis and clinical case scenarios, it serves as a
comprehensive study aid for students preparing for exams, reviewing course material, or seeking
certification.
CONTENTS
01 Cardiovascular Assessment & Diagnosis Q1–Q10
02 Pulmonary & Respiratory Systems Q11–Q18
03 Hematology & Oncology Q19–Q26
04 Dermatology & Ophthalmology Q27–Q38
05 Endocrine & Metabolic Disorders Q39–Q50
06 Gastrointestinal & Hepatic Assessment Q51–Q55
07 Musculoskeletal & Rheumatic Conditions Q56–Q58
08 Renal & Genitourinary Systems Q59–Q70
09 General Assessment & Pathophysiology Q71–Q73
10 Infectious Disease & Immunology Q74–Q81
11 Psychiatric & Behavioral Health Q82–Q85
12 Neurological & Sensory Examination Q86–Q96
13 Additional Questions Q97–Q100
E XA M Q U EST I O N S
Q1 QUESTION 1 OF 100
Page 1
,A nurse practitioner is evaluating a 71-year-old female patient recently discharged following a CHF exacerbation. The hospitalist documented a new cardiac murmur. To assess
the timing of this murmur relative to potential valvular dysfunction, the practitioner anticipates auscultating an S3 or S4 gallop during which phase of the cardiac cycle?
A) Systole
B) Diastole
C) Both systole and diastole concurrently
D) The brief period between S1 and S2
CORRECT ANSWER
Diastole
RATIONALE
S3 and S4 gallops are abnormal low-frequency sounds heard during diastole, indicating ventricular filling abnormalities that are often associated with heart failure or hypertension. Their
presence helps pinpoint dysfunction during the filling phase of the cardiac cycle.
Q2 QUESTION 2 OF 100
A 58-year-old male presents to the clinic with reports of intermittent palpitations. The nurse practitioner performs a physical assessment, noting clear lungs bilaterally and
regular heart rhythm. To best assess for the location of the point of maximal impulse (PMI) in this patient, the practitioner positions him in the left lateral decubitus position
and begins palpation. Which anatomical landmark is the anticipated location for a palpable PMI in a healthy adult in this position?
A) Right 2nd intercostal space, midclavicular line
B) Left 2nd intercostal space, midaxillary line
C) Right 4th intercostal space, sternal border
D) Left 5th intercostal space, midclavicular line
CORRECT ANSWER
D) Left 5th intercostal space, midclavicular line
RATIONALE
Palpating the PMI in the left lateral decubitus position shifts it inferiorly and medially; therefore, the left 5th intercostal space at the midclavicular line is the expected location for most healthy
adults.
Q3 QUESTION 3 OF 100
The nurse practitioner is reviewing the EKG tracing of a 68-year-old female presenting with palpitations and a rapid ventricular response. To assess for a pulse deficit, the
practitioner must accurately correlate the physical heart sounds with the electrical events on the EKG. Where should the first heart sound (S1) be visualized on the EKG tracing?
A) At the peak of the R wave.
B) At the beginning of the P wave.
C) At the end of the T wave.
D) At the beginning of the T wave.
CORRECT ANSWER
A) At the peak of the R wave.
RATIONALE
The first heart sound (S1), often described as "lub," corresponds to the closure of the atrioventricular valves, which occurs at the beginning of ventricular systole, coinciding with the QRS
complex, specifically the peak of the R wave. This timing is critical for identifying a pulse deficit by comparing palpable pulse rate to the EKG rate.
Q4 QUESTION 4 OF 100
A 72-year-old male patient, previously managed for exertional chest pain, presents to the clinic after a diagnostic stress test. The EKG during the test revealed ST segment
depression in leads V3-V4 concurrent with his reported chest discomfort. Which of the following medical decisions is NOT a priority at this time?
A) Prescribe metoprolol 12.5 mg PO BID
B) Refer for cardiac angiography
Page 2
,C) Administer aspirin 81 mg PO daily
D) Obtain thyroid-stimulating hormone levels
CORRECT ANSWER
D) Obtain thyroid-stimulating hormone levels
RATIONALE
ST segment depression during a stress test with concurrent chest pain is a direct indicator of potential myocardial ischemia, necessitating immediate management and further cardiac
evaluation rather than investigating unrelated endocrine causes. These findings warrant prompt cardiac workup and intervention.
Q5 QUESTION 5 OF 100
A nurse practitioner reviews the history of a female patient diagnosed with congestive heart failure (CHF) and an ejection fraction of 35%. The patient reports dyspnea that
occurs only with increased exertion, such as performing activities of daily living, but is absent when at rest. This symptomatic presentation aligns with which New York Heart
Association (NYHA) functional classification of heart failure?
A) Class IV
B) Class I
C) Class III
D) Class II
CORRECT ANSWER
C) Class III
RATIONALE
NYHA Class III is characterized by marked limitation of physical activity, with symptoms occurring during less than ordinary activity but not at rest. Class IV involves symptoms at rest.
Q6 QUESTION 6 OF 100
A 68-year-old female presents to the clinic with a complaint of intermittent palpitations and a sensation of an irregular heartbeat for the past week, which has become
constant over the last 4 days. Her vital signs are: heart rate 105, BP 118/72, respiratory rate 18, and SpO2 98% on room air. An ECG confirms atrial fibrillation with a rapid
ventricular response. The nurse practitioner is developing a plan of care. Which of the following actions should be prioritized?
A) Administer a beta-blocker to slow the heart rate.
B) Initiate a 24-hour Holter monitor to assess rhythm variability.
C) Educate the patient on the risks and benefits of cardioversion.
D) Assess medication adherence and recent dietary changes including caffeine intake.
CORRECT ANSWER
A) Administer a beta-blocker to slow the heart rate.
RATIONALE
The immediate priority in atrial fibrillation with rapid ventricular response is rate control to prevent hemodynamic instability and reduce myocardial oxygen demand. Beta-blockers are a first-
line pharmacologic option for this purpose.
Q7 QUESTION 7 OF 100
A 63-year-old male arrives at the clinic reporting intermittent substernal chest pressure, numbness in his left arm, and dyspnea with inspiration. His history includes poorly
controlled hypertension, type 2 diabetes, hyperlipidemia, and rheumatoid arthritis. He notes the chest pressure, which began three weeks ago, relieves with rest but has not
worsened in frequency or intensity. The nurse practitioner interprets these findings as indicative of which diagnosis and plans management accordingly?
A) Acute myocardial infarction, requiring immediate transfer to the hospital via EMS.
B) Stable angina, managed with initiation of a long-acting oral nitrate.
C) Heart failure, with treatment including carvedilol and a loop diuretic.
D) Unstable angina, necessitating sublingual nitroglycerin and a cardiac stress test.
CORRECT ANSWER
D) Unstable angina, necessitating sublingual nitroglycerin and a cardiac stress test.
Page 3
, RATIONALE
New-onset or changing chest pain in a patient with cardiac risk factors suggests unstable angina, requiring immediate intervention with sublingual nitroglycerin and further diagnostic
workup like a stress test to assess for significant coronary artery disease.
Q8 QUESTION 8 OF 100
A 72-year-old female with a history of CABG and porcine bioprosthetic aortic valve replacement 7 years ago presents to the clinic reporting increasing near-syncope upon
standing over the past 6 months, which she attributed to aging. She has been hemodynamically stable otherwise. The nurse practitioner evaluates for potential cardiac
complications. Which finding requires immediate diagnostic follow-up?
A) Echocardiographic evidence of moderate tricuspid regurgitation.
B) Mild left ventricular hypertrophy with preserved ejection fraction.
C) Progressive stenosis of the bioprosthetic aortic valve.
D) New onset of unstable angina.
CORRECT ANSWER
C) Progressive stenosis of the bioprosthetic aortic valve.
RATIONALE
Progressive stenosis of a bioprosthetic aortic valve is a well-recognized complication that can lead to reduced cardiac output and syncope, directly correlating with her symptoms and
history. Other findings, while potentially serious, do not as directly explain the chief complaint in this specific clinical context.
Q9 QUESTION 9 OF 100
A 62-year-old male with a history of type 2 diabetes, hypertension, and coronary artery disease presents to the clinic complaining of intermittent leg pain that worsens with
walking approximately 2 blocks and resolves with rest. He also reports experiencing numbness in his left foot at rest and thinning of hair on his lower legs over the past 5
months. The nurse practitioner notes diminished posterior tibial pulses bilaterally. Which diagnostic test is most appropriate to confirm a suspected diagnosis?
A) D-dimer assay
B) Venous Doppler ultrasound
C) Ankle-brachial index
D) 2-dimensional echocardiogram
CORRECT ANSWER
C) Ankle-brachial index
RATIONALE
Intermittent claudication, rest pain, and trophic changes are classic signs of peripheral arterial disease, which is confirmed by an ankle-brachial index reflecting reduced arterial blood flow. D-
dimer and venous ultrasound assess for venous thromboembolism, and echocardiography evaluates cardiac function, neither of which aligns with the patient's arterial insufficiency
symptoms.
Q10 QUESTION 10 OF 100
A nurse practitioner reviews the record of a 62-year-old male patient presenting with a new diagnosis of Stage II hypertension, documented as 160/92 mmHg today and
consistently above 140/90 mmHg over the past year. The patient reports a prior attempt at antihypertensive therapy was discontinued due to "kidney problems." The nurse
practitioner suspects secondary causes, specifically renal artery stenosis. Which of the following findings would LEAST support suspicion for renal artery stenosis in this
patient?
A) Onset of hypertension at age 28.
B) Unexplained size discrepancy between the kidneys.
C) Severe, poorly controlled hypertension in a patient 55 years or older.
D) Hypertension effectively managed with two oral medications.
CORRECT ANSWER
D) Hypertension effectively managed with two oral medications.
RATIONALE
Hypertension controlled on two medications suggests a primary or essential hypertension etiology, whereas uncontrolled, early-onset, or asymmetric renal findings are more indicative of
secondary causes like renal artery stenosis.
Page 4
P R O F E S S I O N A L P R A C T I C E M AT E R I A L S
NR 547 CEA Final Exam Questions & Answers
Test Bank | Advanced Practice Health
Assessment, System-Based Diagnosis &
Clinical Case Scenarios | Chamberlain |
2026/2027
Verified Answers Exam Ready With Rationales
100 QUESTIONS
DOCUMENT OVERVIEW
This document provides 100 advanced practice health assessment questions with their correct answers and
detailed explanations. Covering system-based diagnosis and clinical case scenarios, it serves as a
comprehensive study aid for students preparing for exams, reviewing course material, or seeking
certification.
CONTENTS
01 Cardiovascular Assessment & Diagnosis Q1–Q10
02 Pulmonary & Respiratory Systems Q11–Q18
03 Hematology & Oncology Q19–Q26
04 Dermatology & Ophthalmology Q27–Q38
05 Endocrine & Metabolic Disorders Q39–Q50
06 Gastrointestinal & Hepatic Assessment Q51–Q55
07 Musculoskeletal & Rheumatic Conditions Q56–Q58
08 Renal & Genitourinary Systems Q59–Q70
09 General Assessment & Pathophysiology Q71–Q73
10 Infectious Disease & Immunology Q74–Q81
11 Psychiatric & Behavioral Health Q82–Q85
12 Neurological & Sensory Examination Q86–Q96
13 Additional Questions Q97–Q100
E XA M Q U EST I O N S
Q1 QUESTION 1 OF 100
Page 1
,A nurse practitioner is evaluating a 71-year-old female patient recently discharged following a CHF exacerbation. The hospitalist documented a new cardiac murmur. To assess
the timing of this murmur relative to potential valvular dysfunction, the practitioner anticipates auscultating an S3 or S4 gallop during which phase of the cardiac cycle?
A) Systole
B) Diastole
C) Both systole and diastole concurrently
D) The brief period between S1 and S2
CORRECT ANSWER
Diastole
RATIONALE
S3 and S4 gallops are abnormal low-frequency sounds heard during diastole, indicating ventricular filling abnormalities that are often associated with heart failure or hypertension. Their
presence helps pinpoint dysfunction during the filling phase of the cardiac cycle.
Q2 QUESTION 2 OF 100
A 58-year-old male presents to the clinic with reports of intermittent palpitations. The nurse practitioner performs a physical assessment, noting clear lungs bilaterally and
regular heart rhythm. To best assess for the location of the point of maximal impulse (PMI) in this patient, the practitioner positions him in the left lateral decubitus position
and begins palpation. Which anatomical landmark is the anticipated location for a palpable PMI in a healthy adult in this position?
A) Right 2nd intercostal space, midclavicular line
B) Left 2nd intercostal space, midaxillary line
C) Right 4th intercostal space, sternal border
D) Left 5th intercostal space, midclavicular line
CORRECT ANSWER
D) Left 5th intercostal space, midclavicular line
RATIONALE
Palpating the PMI in the left lateral decubitus position shifts it inferiorly and medially; therefore, the left 5th intercostal space at the midclavicular line is the expected location for most healthy
adults.
Q3 QUESTION 3 OF 100
The nurse practitioner is reviewing the EKG tracing of a 68-year-old female presenting with palpitations and a rapid ventricular response. To assess for a pulse deficit, the
practitioner must accurately correlate the physical heart sounds with the electrical events on the EKG. Where should the first heart sound (S1) be visualized on the EKG tracing?
A) At the peak of the R wave.
B) At the beginning of the P wave.
C) At the end of the T wave.
D) At the beginning of the T wave.
CORRECT ANSWER
A) At the peak of the R wave.
RATIONALE
The first heart sound (S1), often described as "lub," corresponds to the closure of the atrioventricular valves, which occurs at the beginning of ventricular systole, coinciding with the QRS
complex, specifically the peak of the R wave. This timing is critical for identifying a pulse deficit by comparing palpable pulse rate to the EKG rate.
Q4 QUESTION 4 OF 100
A 72-year-old male patient, previously managed for exertional chest pain, presents to the clinic after a diagnostic stress test. The EKG during the test revealed ST segment
depression in leads V3-V4 concurrent with his reported chest discomfort. Which of the following medical decisions is NOT a priority at this time?
A) Prescribe metoprolol 12.5 mg PO BID
B) Refer for cardiac angiography
Page 2
,C) Administer aspirin 81 mg PO daily
D) Obtain thyroid-stimulating hormone levels
CORRECT ANSWER
D) Obtain thyroid-stimulating hormone levels
RATIONALE
ST segment depression during a stress test with concurrent chest pain is a direct indicator of potential myocardial ischemia, necessitating immediate management and further cardiac
evaluation rather than investigating unrelated endocrine causes. These findings warrant prompt cardiac workup and intervention.
Q5 QUESTION 5 OF 100
A nurse practitioner reviews the history of a female patient diagnosed with congestive heart failure (CHF) and an ejection fraction of 35%. The patient reports dyspnea that
occurs only with increased exertion, such as performing activities of daily living, but is absent when at rest. This symptomatic presentation aligns with which New York Heart
Association (NYHA) functional classification of heart failure?
A) Class IV
B) Class I
C) Class III
D) Class II
CORRECT ANSWER
C) Class III
RATIONALE
NYHA Class III is characterized by marked limitation of physical activity, with symptoms occurring during less than ordinary activity but not at rest. Class IV involves symptoms at rest.
Q6 QUESTION 6 OF 100
A 68-year-old female presents to the clinic with a complaint of intermittent palpitations and a sensation of an irregular heartbeat for the past week, which has become
constant over the last 4 days. Her vital signs are: heart rate 105, BP 118/72, respiratory rate 18, and SpO2 98% on room air. An ECG confirms atrial fibrillation with a rapid
ventricular response. The nurse practitioner is developing a plan of care. Which of the following actions should be prioritized?
A) Administer a beta-blocker to slow the heart rate.
B) Initiate a 24-hour Holter monitor to assess rhythm variability.
C) Educate the patient on the risks and benefits of cardioversion.
D) Assess medication adherence and recent dietary changes including caffeine intake.
CORRECT ANSWER
A) Administer a beta-blocker to slow the heart rate.
RATIONALE
The immediate priority in atrial fibrillation with rapid ventricular response is rate control to prevent hemodynamic instability and reduce myocardial oxygen demand. Beta-blockers are a first-
line pharmacologic option for this purpose.
Q7 QUESTION 7 OF 100
A 63-year-old male arrives at the clinic reporting intermittent substernal chest pressure, numbness in his left arm, and dyspnea with inspiration. His history includes poorly
controlled hypertension, type 2 diabetes, hyperlipidemia, and rheumatoid arthritis. He notes the chest pressure, which began three weeks ago, relieves with rest but has not
worsened in frequency or intensity. The nurse practitioner interprets these findings as indicative of which diagnosis and plans management accordingly?
A) Acute myocardial infarction, requiring immediate transfer to the hospital via EMS.
B) Stable angina, managed with initiation of a long-acting oral nitrate.
C) Heart failure, with treatment including carvedilol and a loop diuretic.
D) Unstable angina, necessitating sublingual nitroglycerin and a cardiac stress test.
CORRECT ANSWER
D) Unstable angina, necessitating sublingual nitroglycerin and a cardiac stress test.
Page 3
, RATIONALE
New-onset or changing chest pain in a patient with cardiac risk factors suggests unstable angina, requiring immediate intervention with sublingual nitroglycerin and further diagnostic
workup like a stress test to assess for significant coronary artery disease.
Q8 QUESTION 8 OF 100
A 72-year-old female with a history of CABG and porcine bioprosthetic aortic valve replacement 7 years ago presents to the clinic reporting increasing near-syncope upon
standing over the past 6 months, which she attributed to aging. She has been hemodynamically stable otherwise. The nurse practitioner evaluates for potential cardiac
complications. Which finding requires immediate diagnostic follow-up?
A) Echocardiographic evidence of moderate tricuspid regurgitation.
B) Mild left ventricular hypertrophy with preserved ejection fraction.
C) Progressive stenosis of the bioprosthetic aortic valve.
D) New onset of unstable angina.
CORRECT ANSWER
C) Progressive stenosis of the bioprosthetic aortic valve.
RATIONALE
Progressive stenosis of a bioprosthetic aortic valve is a well-recognized complication that can lead to reduced cardiac output and syncope, directly correlating with her symptoms and
history. Other findings, while potentially serious, do not as directly explain the chief complaint in this specific clinical context.
Q9 QUESTION 9 OF 100
A 62-year-old male with a history of type 2 diabetes, hypertension, and coronary artery disease presents to the clinic complaining of intermittent leg pain that worsens with
walking approximately 2 blocks and resolves with rest. He also reports experiencing numbness in his left foot at rest and thinning of hair on his lower legs over the past 5
months. The nurse practitioner notes diminished posterior tibial pulses bilaterally. Which diagnostic test is most appropriate to confirm a suspected diagnosis?
A) D-dimer assay
B) Venous Doppler ultrasound
C) Ankle-brachial index
D) 2-dimensional echocardiogram
CORRECT ANSWER
C) Ankle-brachial index
RATIONALE
Intermittent claudication, rest pain, and trophic changes are classic signs of peripheral arterial disease, which is confirmed by an ankle-brachial index reflecting reduced arterial blood flow. D-
dimer and venous ultrasound assess for venous thromboembolism, and echocardiography evaluates cardiac function, neither of which aligns with the patient's arterial insufficiency
symptoms.
Q10 QUESTION 10 OF 100
A nurse practitioner reviews the record of a 62-year-old male patient presenting with a new diagnosis of Stage II hypertension, documented as 160/92 mmHg today and
consistently above 140/90 mmHg over the past year. The patient reports a prior attempt at antihypertensive therapy was discontinued due to "kidney problems." The nurse
practitioner suspects secondary causes, specifically renal artery stenosis. Which of the following findings would LEAST support suspicion for renal artery stenosis in this
patient?
A) Onset of hypertension at age 28.
B) Unexplained size discrepancy between the kidneys.
C) Severe, poorly controlled hypertension in a patient 55 years or older.
D) Hypertension effectively managed with two oral medications.
CORRECT ANSWER
D) Hypertension effectively managed with two oral medications.
RATIONALE
Hypertension controlled on two medications suggests a primary or essential hypertension etiology, whereas uncontrolled, early-onset, or asymmetric renal findings are more indicative of
secondary causes like renal artery stenosis.
Page 4
